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1. Worldwide Survey of COVID-19–Associated Arrhythmias

Author

Coromilas, Ellie J, Kochav, Stephanie, Goldenthal, Isaac, Biviano, Angelo, Garan, Hasan, Goldbarg, Seth, Kim, Joon-Hyuk, Yeo, Ilhwan, Tracy, Cynthia, Ayanian, Shant, Akar, Joseph, Singh, Avinainder, Jain, Shashank, Zimerman, Leandro, Pimentel, Maurício, Osswald, Stefan, Twerenbold, Raphael, Schaerli, Nicolas, Crotti, Lia, Fabbri, Daniele, Parati, Gianfranco, Li, Yi, Atienza, Felipe, Zatarain, Eduardo, Tse, Gary, Leung, Keith Sai Kit, Guevara-Valdivia, Milton E, Rivera-Santiago, Carlos A, Soejima, Kyoko, De Filippo, Paolo, Ferrari, Paola, Malanchini, Giovanni, Kanagaratnam, Prapa, Khawaja, Saud, Mikhail, Ghada W, Scanavacca, Mauricio, Hajjar, Ludhmila Abrahão, Rizerio, Brenno, Sacilotto, Luciana, Mollazadeh, Reza, Eslami, Masoud, far, Vahideh Laleh, Mattioli, Anna Vittoria, Boriani, Giuseppe, Migliore, Federico, Cipriani, Alberto, Donato, Filippo, Compagnucci, Paolo, Casella, Michela, Dello Russo, Antonio, Coromilas, James, Aboyme, Andrew, O’Brien, Connor Galen, Rodriguez, Fatima, Wang, Paul J, Naniwadekar, Aditi, Moey, Melissa, Kow, Chia Siang, Cheah, Wee Kooi, Auricchio, Angelo, Conte, Giulio, Hwang, Jongmin, Han, Seongwook, Lazzerini, Pietro Enea, Franchi, Federico, Santoro, Amato, Capecchi, Pier Leopoldo, Joglar, Jose A, Rosenblatt, Anna G, Zardini, Marco, Bricoli, Serena, Bonura, Rosario, Echarte-Morales, Julio, Benito-González, Tomás, Minguito-Carazo, Carlos, Fernández-Vázquez, Felipe, and Wan, Elaine Y

Subjects
Biomedical and Clinical Sciences, Medical Physiology, Cardiovascular Medicine and Haematology, Clinical Sciences, Aged, Arrhythmias, Cardiac, COVID-19, Cardiac Electrophysiology, Comorbidity, Electrophysiologic Techniques, Cardiac, Female, Global Health, Health Care Surveys, Healthcare Disparities, Humans, Incidence, Male, Middle Aged, Practice Patterns, Physicians', Prevalence, Prognosis, Retrospective Studies, Risk Assessment, Time Factors, arrhythmia, atrial fibrillation, atrial flutter, bradycardia, tachycardia, torsade de pointes, Cardiorespiratory Medicine and Haematology, Cardiovascular System & Hematology, Cardiovascular medicine and haematology, Clinical sciences, Medical physiology
Abstract

[Figure: see text].

Published
2021

2. Matching Ablation Endpoints to Long-Term Outcome: The Prospective Multicenter Italian Ventricular Tachycardia Ablation Registry

Author

Radinovic, Andrea, Peretto, Giovanni, Sgarito, Giuseppe, Cauti, Filippo Maria, Castro, Antonello, Narducci, Maria Lucia, Mantovan, Roberto, Scaglione, Marco, Solimene, Francesco, Scopinaro, Alice, Tondo, Claudio, Filippini, Giulia, Bianco, Elisabetta, Bonso, Aldo, Calzolari, Vittorio, Ferraris, Federico, Zardini, Marco, Piacenti, Marcello, D’Angelo, Giuseppe, Bosica, Francesco, and Della Bella, Paolo

Published
2023
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3. Implantation of cardiac electronic devices in active COVID-19 patients: Results from an international survey

Author

Tovia-Brodie, Oholi, Rav Acha, Moshe, Belhassen, Bernard, Gasperetti, Alessio, Schiavone, Marco, Forleo, Giovanni Battista, Guevara-Valdivia, Milton E., Ruiz, David Valdeolivar, Lellouche, Nicolas, Hamon, David, Castagno, Davide, Bellettini, Matteo, De Ferrari, Gaetano M., Laredo, Mikael, Carvès, Jean-Baptiste, Ignatiuk, Barbara, Pasquetto, Giampaolo, De Filippo, Paolo, Malanchini, Giovanni, Pavri, Behzad B., Raphael, Craig, Rivetti, Luigi, Mantovan, Roberto, Chinitz, Jason, Harding, Melissa, Boriani, Giuseppe, Casali, Edoardo, Wan, Elaine Y., Biviano, Angelo, Macias, Carlos, Havranek, Stepan, Lazzerini, Pietro Enea, Canu, Antonio M., Zardini, Marco, Conte, Giulio, Cano, Óscar, Casella, Michela, Rudic, Boris, Omelchenko, Alexander, Mathuria, Nilesh, Upadhyay, Gaurav A., Danon, Asaf, Schwartz, Arie Lorin, Maury, Philippe, Nakahara, Shiro, Goldenberg, Gustavo, Schaerli, Nicolas, Bereza, Sergiy, Auricchio, Angelo, Glikson, Michael, and Michowitz, Yoav

Published
2022
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6. Incremental value of atrial sensing in the diagnosis of ICD recordings: findings from the THINGS registry

Author

Carinci, Valeria, primary, Ziacchi, Matteo, additional, Iori, Matteo, additional, De Maria, Elia, additional, Bolognesi, Maria Giulia, additional, Zardini, Marco, additional, Calvi, Valeria, additional, Allocca, Giuseppe, additional, Ammendola, Ernesto, additional, Boggian, Giulio, additional, Saporito, Davide, additional, Giorgi, Davide, additional, Statuto, Giovanni, additional, Giacopelli, Daniele, additional, Grassini, Diego, additional, and Biffi, Mauro, additional

Published
2022
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10. Heart rate distribution in paced and non-paced patients with severe recurrent reflex syncope and tilt-induced asystole: Findings from the BIOSync CLS study

Author

Russo, Vincenzo, primary, Anguera, Ignasi, additional, de Lange, Frederik J., additional, De Ruvo, Ermenegildo, additional, Taieb, Jérôme, additional, Zardini, Marco, additional, Nigro, Gerardo, additional, Giacopelli, Daniele, additional, Gargaro, Alessio, additional, and Brignole, Michele, additional

Published
2021
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12. Comparison of 1-year effects of left ventricular and biventricular pacing in patients with heart failure who have ventricular arrhythmias and left bundle-branch block: The Bi vs Left Ventricular Pacing: An International Pilot Evaluation on Heart Failure Patients with Ventricular Arrhythmias (BELIEVE) multicenter prospective randomized pilot study

Author

Gasparini, Maurizio, Bocchiardo, Mario, Lunati, Maurizio, Ravazzi, Pier Antonio, Santini, Massimo, Zardini, Marco, Signorelli, Silvia, Passardi, Micaela, and Klersy, Catherine

Published
2006

14. Out-of-hospital cardiac arrest due to idiopathic ventricular fibrillation in patients with normal electrocardiograms:results from a multicentre long-term registry

Author

Conte, Giulio, Belhassen, Bernard, Lambiase, Pier, Ciconte, Giuseppe, de Asmundis, Carlo, Arbelo, Elena, Schaer, Beat, Frontera, Antonio, Burri, Haran, Calo', Leonardo, Letsas, Kostantinos P., Leyva, Francisco, Porter, Bradley, Saenen, Johan, Zacà, Valerio, Berne, Paola, Ammann, Peter, Zardini, Marco, Luani, Blerim, Rordorf, Roberto, Sarquella Brugada, Georgia, Medeiros-Domingo, Argelia, Geller, Johann Christoph, de Potter, Tom, Stokke, Mathis K., Márquez, Manlio F., Michowitz, Yoav, Honarbakhsh, Shohreh, Conti, Manuel, Sticherling, Christian, Martino, Annamaria, Zegard, Abbasin, Özkartal, Tardu, Caputo, Maria Luce, Regoli, François, Braun-Dullaeus, Rüdiger C., Notarangelo, Francesca, Moccetti, Tiziano, Casu, Gavino, Rinaldi, Christopher A., Levinstein, Moises, Haugaa, Kristina H., Derval, Nicolas, Klersy, Catherine, Curti, Moreno, Pappone, Carlo, Heidbuchel, Hein, Brugada, Josép, Haïssaguerre, Michel, Brugada, Pedro, and Auricchio, Angelo

Abstract

AIMS : To define the clinical characteristics and long-term clinical outcomes of a large cohort of patients with idiopathic ventricular fibrillation (IVF) and normal 12-lead electrocardiograms (ECGs). METHODS AND RESULTS: Patients with ventricular fibrillation as the presenting rhythm, normal baseline, and follow-up ECGs with no signs of cardiac channelopathy including early repolarization or atrioventricular conduction abnormalities, and without structural heart disease were included in a registry. A total of 245 patients (median age: 38 years; males 59%) were recruited from 25 centres. An implantable cardioverter-defibrillator (ICD) was implanted in 226 patients (92%), while 18 patients (8%) were treated with drug therapy only. Over a median follow-up of 63 months (interquartile range: 25-110 months), 12 patients died (5%); in four of them (1.6%) the lethal event was of cardiac origin. Patients treated with antiarrhythmic drugs only had a higher rate of cardiovascular death compared to patients who received an ICD (16% vs. 0.4%, P = 0.001). Fifty-two patients (21%) experienced an arrhythmic recurrence. Age ≤16 years at the time of the first ventricular arrhythmia was the only predictor of arrhythmic recurrence on multivariable analysis [hazard ratio (HR) 0.41, 95% confidence interval (CI) 0.18-0.92; P = 0.03]. CONCLUSION : Patients with IVF and persistently normal ECGs frequently have arrhythmic recurrences, but a good prognosis when treated with an ICD. Children are a category of IVF patients at higher risk of arrhythmic recurrences.

Published
2019

16. Out-of-hospital cardiac arrest due to idiopathic ventricular fibrillation in patients with normal electrocardiograms: results from a multicentre long-term registry

Author

Conte, Giulio, primary, Belhassen, Bernard, additional, Lambiase, Pier, additional, Ciconte, Giuseppe, additional, de Asmundis, Carlo, additional, Arbelo, Elena, additional, Schaer, Beat, additional, Frontera, Antonio, additional, Burri, Haran, additional, Calo’, Leonardo, additional, Letsas, Kostantinos P, additional, Leyva, Francisco, additional, Porter, Bradley, additional, Saenen, Johan, additional, Zacà, Valerio, additional, Berne, Paola, additional, Ammann, Peter, additional, Zardini, Marco, additional, Luani, Blerim, additional, Rordorf, Roberto, additional, Sarquella Brugada, Georgia, additional, Medeiros-Domingo, Argelia, additional, Geller, Johann-Christoph, additional, de Potter, Tom, additional, Stokke, Mathis K, additional, Márquez, Manlio F, additional, Michowitz, Yoav, additional, Honarbakhsh, Shohreh, additional, Conti, Manuel, additional, Sticherling, Christian, additional, Martino, Annamaria, additional, Zegard, Abbasin, additional, Özkartal, Tardu, additional, Caputo, Maria Luce, additional, Regoli, François, additional, Braun-Dullaeus, Rüdiger C, additional, Notarangelo, Francesca, additional, Moccetti, Tiziano, additional, Casu, Gavino, additional, Rinaldi, Christopher A, additional, Levinstein, Moises, additional, Haugaa, Kristina H, additional, Derval, Nicolas, additional, Klersy, Catherine, additional, Curti, Moreno, additional, Pappone, Carlo, additional, Heidbuchel, Hein, additional, Brugada, Josép, additional, Haïssaguerre, Michel, additional, Brugada, Pedro, additional, and Auricchio, Angelo, additional

Published
2019
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17. Idiopathic Ventricular Fibrillation and Otherwise Normal Electrocardiograms

Author

Conte, Giulio, primary, Belhassen, Bernard, additional, Lambiase, Pier, additional, Ciconte, Giuseppe, additional, de Asmundis, Carlo, additional, Arbelo, Elena, additional, Schaer, Beat, additional, Frontera, Antonio, additional, Burri, Haran, additional, Calo, Leonardo, additional, Letsas, Kostantinos P., additional, Leyva, Francisco, additional, Porter, Bradley, additional, Saenen, Johan, additional, Zacà, Valerio, additional, Berne, Paola, additional, Ammann, Peter, additional, Zardini, Marco, additional, Luani, Blerim, additional, Rordorf, Roberto, additional, Sarquella Brugada, Georgia, additional, Medeiros-Domingo, Argelia, additional, Geller, Johann-Christoph, additional, de Potter, Tom, additional, Stokke, Mathis K., additional, Márquez, Manlio F., additional, Michowitz, Yoav, additional, Honarbakhsh, Shohreh, additional, Conti, Manuel, additional, Sticherling, Christian, additional, Martino, Annamaria, additional, Zegard, Abbasin, additional, Özkartal, Tardu, additional, Luce Caputo, Maria, additional, Regoli, François, additional, Braun-Dullaeus, Rüdiger C., additional, Notarangelo, Francesca, additional, Moccetti, Tiziano, additional, Casu, Gavino, additional, Rinaldi, Christopher A, additional, Levinstein, Moises, additional, Haugaa, Kristina H., additional, Derval, Nicolas, additional, Klersy, Catherine, additional, Curti, Moreno, additional, Pappone, Carlo, additional, Heidbuchel, Hein, additional, Brugada, Josép, additional, Haïssaguerre, Michel, additional, Brugada, Pedro, additional, and Auricchio, Angelo, additional

Published
2019
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19. Internal Jugular Vein Complete Thrombosis After Dual Chamber Pacemaker Implant

Author

Placci, Angelo, Mattioli, Maria, Notarangelo, Maria Francesca, Gonzi, Gianluca, and Zardini, Marco

Subjects
Case Report
Abstract

Venous thrombosis after pacemaker implant is a known, although often underrecognized condition that can challenge system revision or upgrading, leading occasionally to thromboembolic complications. Several factors are considered to promote thrombus formation. Among them, alteration of blood flow mechanics due to the presence of catheters in the vessel lumen may itself play a pivotal role. Hereby we present the case of a 65-year old men who underwent a dual-chamber pacemaker implant in another institute for sick sinus syndrome by means of left cephalic venous access. About two months later he started experiencing neck swelling, pain and dysphagia. Six months later, ultrasonography and CT-scan revealed complete jugular vein thrombosis caused by a lead loop at the level of the left subclavian vein. Of note, thrombosis occurred despite proper oral anticoagulation with warfarin undertaken for coexisting atrial fibrillation. It’s important to keep in mind this possible complication of pacemaker implant to allow for early diagnosis and better treatment chances. This case report is an example of how proximal catheter displacement may promote thrombus formation, probably by affecting blood flow mechanics, even in spite of proper oral anticoagulation.

Published
2016

20. Left Ventricular Reverse Remodeling Elicited by a Quadripolar Lead: Results from the Multicenter Per4mer Study

Author

Ziacchi, Matteo, Saporito, Davide, Zardini, Marco, Luzi, Mario, Quartieri, Fabio, Morgagni, Gianluigi, De Maria, Elia, Bertini, Matteo, Carinci, Valeria, Boriani, Giuseppe, and Biffi, Mauro

Subjects
Heart Failure, Male, Ventricular Remodeling, short-spaced quadripolar lead, Left, cardiac resynchronization therapy, heart failure, reverse remodeling, Aged, Equipment Design, Equipment Failure Analysis, Female, Humans, Italy, Treatment Outcome, Ventricular Dysfunction, Left, Cardiac Resynchronization Therapy Devices, Electrodes, Implanted, Cardiology and Cardiovascular Medicine, NO, Ventricular Dysfunction, Implanted, Electrodes
Abstract

To understand the impact of a quadripolar left ventricular (LV) lead on reverse remodeling and phrenic nerve stimulation (PNS) in congestive heart failure patients treated by cardiac resynchronization therapy at 8-month follow-up (FU).One hundred and fifty-eight patients received an LV Medtronic Performa lead (Medtronic Inc., Minneapolis, MN, USA) and were reevaluated at FU by echocardiography and measurement of electrical parameters.A targeted LV lead placement was achieved in 140 (89%) patients. Super responders and responders were 76 (50%) and 26 (18%), respectively, at FU; seven (4%) died and 13 (8%) were hospitalized for any cause. Nonischemic etiology was the only independent predictor of reverse remodeling. The configurations available only with the Performa leads reduced PNS occurrence at 8 V@0.4 ms from 43 (27%) to 14 (9%) of patients at implantation, and from 44 (28%) to 19 (12%) at last FU, compared to configurations available with bipolar leads. Patients with detectable PNS had10/16 pacing configurations with a PNS safety margin2 V both at implantation and at FU. During FU 16 (10%) patients had an adverse event possibly related to the lead or to modification of the underlying heart disease but 99% of these events were fixed by reprogramming of the pacing vector.Performa Lead enables an increased capability to achieve a targeted lead positioning in the broad clinical scenario of large- and small-volume implanting centers, with a relevant impact on the occurrence of reverse remodeling compared to literature data. The enhanced management of PNS resulted in a dislodgement rate of only 1%.

Published
2015

21. 96-44: Atrial sensing stability in single-lead ICD with floating dipole: preliminary observations from the THINGS registry

Author

Carinci, Valeria, primary, Calvi, Valeria, additional, Ammendola, Ernesto, additional, Allocca, Giuseppe, additional, De Maria, Elia, additional, Giorgi, Davide, additional, Saporito, Davide, additional, Bertini, Matteo, additional, Boggian, Giulio, additional, Zardini, Marco, additional, Grassini, Diego, additional, Daniele, Giacopelli, additional, and Biffi, Mauro, additional

Published
2016
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22. Cardiac device therapy in patients with left ventricular dysfunction and heart failure: 'real-world' data on long-term outcomes (mortality, hospitalizations, days alive and out of hospital).

Author

Boriani, Giuseppe, Berti, Elena, Belotti, Laura Maria Beatrice, Biffi, Mauro, De Palma, Rossana, Malavasi, Vincenzo L., Bottoni, Nicola, Rossi, Luca, De Maria, Elia, Mantovan, Roberto, Zardini, Marco, Casali, Edoardo, Marconi, Marco, Bandini, Alberto, Tomasi, Corrado, Boggian, Giulio, Barbato, Gaetano, Toselli, Tiziano, Zennaro, Mauro, and Sassone, Biagio

Subjects
HEART failure patients, MORTALITY, HOSPITAL care, DEFIBRILLATORS, PHYSICIAN practice patterns
Abstract

Background: The impact on long-term outcomes of implantable cardioverter defibrillators (ICDs) and biventricular defibrillators for cardiac resynchronization (CRT-D) devices in 'real world' patients with heart failure (HF) needs to be assessed in terms of clinical effectiveness.Methods and Results: A registry including consecutive HF patients who underwent a first implant of an ICD (891 patients) or a CRT-D device (709 patients) in 2006-2010 was followed (median 1487 days and 1516 days, respectively), collecting administrative data on survival, all-cause hospitalizations, cardiovascular or HF hospitalizations, and days alive and out of hospital (DAOH). Survival free from death/cardiac transplant was 61.9% and 63.8% at 5 years for ICD and CRT-D patients, respectively. Associated comorbidities (Charlson Comorbidity Index) had a significant impact on death/cardiac transplant, as well as on hospitalizations. The median values of DAOH% were 97.4% for ICD and 97.7% for CRT-D patients, but data were highly skewed, with the lower quartile of DAOH% values including values ranging between 0% and 52.8% for ICD and between 0% and 56.1% for CRT-D patients. Charlson Comorbidity Index was a very strong predictor of DAOH%.Conclusions: Patients who were implanted in 'real world' clinical practice with an ICD or a CRT-D device have, on average, a relatively favourable outcome, with a survival of around 62-64% at 5 years, but with an important burden of hospitalizations. Comorbidities, as evaluated by means of the Charlson Comorbidity Index, have a significant impact on outcomes in terms of mortality/heart transplant, hospitalizations and days spent alive and out of hospital. [ABSTRACT FROM AUTHOR]

Published
2016
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23. Cardiac device therapy in patients with left ventricular dysfunction and heart failure: 'realworld' data on long-term outcomes (mortality, hospitalizations, days alive and out of hospital).

Author

Boriani, Giuseppe, Berti, Elena, Beatrice Belotti, Laura Maria, Biffi, Mauro, Palma, Rossana De, Malavasi, Vincenzo L., Bottoni, Nicola, Rossi, Luca, Maria, Elia De, Mantovan, Roberto, Zardini, Marco, Casali, Edoardo, Marconi, Marco, Bandini, Alberto, Tomasi, Corrado, Boggian, Giulio, Barbato, Gaetano, Toselli, Tiziano, Zennaro, Mauro, and Sassone, Biagio

Abstract

Background: The impact on long-term outcomes of implantable cardioverter defibrillators (ICDs) and biventricular defibrillators for cardiac resynchronization (CRT-D) devices in 'real world' patients with heart failure (HF) needs to be assessed in terms of clinical effectiveness. Methods and results: A registry including consecutive HF patients who underwent a first implant of an ICD (891 patients) or a CRT-D device (709 patients) in 2006-2010 was followed (median 1487 days and 1516 days, respectively), collecting administrative data on survival, all-cause hospitalizations, cardiovascular or HF hospitalizations, and days alive and out of hospital (DAOH). Survival free from death/cardiac transplant was 61.9% and 63.8% at 5 years for ICD and CRT-D patients, respectively. Associated comorbidities (Charlson Comorbidity Index) had a significant impact on death/cardiac transplant, as well as on hospitalizations. The median values of DAOH% were 97.4% for ICD and 97.7% for CRT-D patients, but data were highly skewed, with the lower quartile of DAOH% values including values ranging between 0% and 52.8% for ICD and between 0% and 56.1% for CRT-D patients. Charlson Comorbidity Index was a very strong predictor of DAOH%. Conclusions: Patients who were implanted in 'real world' clinical practice with an ICD or a CRT-D device have, on average, a relatively favourable outcome, with a survival of around 62-64% at 5 years, but with an important burden of hospitalizations. Comorbidities, as evaluated by means of the Charlson Comorbidity Index, have a significant impact on outcomes in terms of mortality/heart transplant, hospitalizations and days spent alive and out of hospital. [ABSTRACT FROM AUTHOR]

Published
2016
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29. Preexcited Tachycardia:.

Author

TRITTO, MASSIMO, primary, PONTI, ROBERTO, additional, ZARDINI, MARCO, additional, FANG, PIHUA, additional, and SALERNO-URIARTE, JORGE A., additional

Published
2000
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44. Preexcited Tachycardia: What is the Tachycardia Mechanism?

Author

Tritto, Massimo, De Ponti, Roberto, Zardini, Marco, Fang, Pihua, and Salerno-Uriarte, Jorge A.

Subjects
TACHYCARDIA, ELECTROPHYSIOLOGY, CATHETER ablation, RADIO frequency, ARRHYTHMIA, HEART diseases
Abstract

The article discusses the medical case of preexcited tachycardia. A 29-year-old woman with Wolff-Parkinson-White syndrome underwent electrophysiologic study and radiofrequency catheter ablation because of frequent episodes of paroxysmal tachycardia not controlled by medical therapy. Atrial activations during tachycardia and ventricular pacing at the same tachycardia rate were similar. Careful inspection of the His-bundle electrograms during tachycardia reveals a proximal-to-distal activation sequence. The accessory pathway was ablated with a single radiofrequency current pulse delivered at the posteromedial tricuspid ring.

Published
2000
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45. Heart rate distribution in paced and non-paced patients with severe recurrent reflex syncope and tilt-induced asystole: Findings from the BIOSync CLS study

Author

Daniele Giacopelli, Alessio Gargaro, Vincenzo Russo, Marco Zardini, Jérôme Taieb, Ignasi Anguera, Gerardo Nigro, Ermenegildo De Ruvo, Frederik J. de Lange, Michele Brignole, Russo, Vincenzo, Anguera, Ignasi, de Lange, Frederik J, De Ruvo, Ermenegildo, Taieb, Jérôme, Zardini, Marco, Nigro, Gerardo, Giacopelli, Daniele, Gargaro, Alessio, Brignole, Michele, Cardiology, and ACS - Heart failure & arrhythmias

Subjects
Pacemaker, Artificial, medicine.medical_specialty, Heart rate, 030204 cardiovascular system & hematology, Syncope, 03 medical and health sciences, 0302 clinical medicine, CLs upper limits, Clinical trials, Tilt testing, Interquartile range, Internal medicine, Reflex, Syncope, Vasovagal, Humans, Medicine, Distribution (pharmacology), 030212 general & internal medicine, Reflex syncope, Asystole, Marcapassos, Vagovagal reflex, business.industry, Cardiac Pacing, Artificial, Cardiac pacemakers, medicine.disease, Atrioventricular node, Heart Arrest, Closed loop stimulation, Pacemaker, medicine.anatomical_structure, Cardiac pacing, Syncope (Pathology), Cardiology, Síncope (Patologia), Cardiology and Cardiovascular Medicine, business, Assaigs clínics
Abstract

Background Undiagnosed sinus or atrioventricular node dysfunction may bias estimation of the real efficacy of cardiac pacing in preventing vasovagal reflex syncope. We assessed this hypothesis in the BIOSync CLS trial which showed that dual-chamber pacing with closed loop stimulation (CLS) remarkably reduced recurrences of syncope. Methods and results In the study patients aged 40 years or older with ≥2 episodes of loss of consciousness in the last year and an asystolic response to Tilt-Table test were randomized to pacing ON (DDD-CLS mode) or pacing OFF (ODO mode). We utilized the available pacemaker diagnostic data in a total of 103 patients (52 pacing ON, 51 pacing OFF) to generate cumulative distribution charts for heart rate (HR) and percentage of pacing. At 12 months, we did not find evidence of suspected sinus or atrioventricular node dysfunction. Beats were similarly distributed between groups (p = 0.96), with an average HR of 76 ± 8 bpm (pacing ON) versus 77 ± 7 bpm (pacing OFF). In the active group, the median percentage of atrial and ventricular pacing was 47% and 0%, respectively. Intolerance to high pacing rates was reported in only one patient (1.6%) and was easily resolved by reprogramming the maximum CLS pacing rate. Conclusions We did not find evidence of suspected sinus or atrioventricular node dysfunction in the BIOSync CLS patients. The benefit of pacing should be ascribed to pacing prevention of pure vasovagal episodes. CLS algorithm modulated pacing rates over a wide frequency range, consistently competing with sinus node.

Published
2021

46. Out-of-hospital cardiac arrest due to idiopathic ventricular fibrillation in patients with normal electrocardiograms: results from a multicentre long-term registry.

Author

Conte G, Belhassen B, Lambiase P, Ciconte G, de Asmundis C, Arbelo E, Schaer B, Frontera A, Burri H, Calo' L, Letsas KP, Leyva F, Porter B, Saenen J, Zacà V, Berne P, Ammann P, Zardini M, Luani B, Rordorf R, Sarquella Brugada G, Medeiros-Domingo A, Geller JC, de Potter T, Stokke MK, Márquez MF, Michowitz Y, Honarbakhsh S, Conti M, Sticherling C, Martino A, Zegard A, Özkartal T, Caputo ML, Regoli F, Braun-Dullaeus RC, Notarangelo F, Moccetti T, Casu G, Rinaldi CA, Levinstein M, Haugaa KH, Derval N, Klersy C, Curti M, Pappone C, Heidbuchel H, Brugada J, Haïssaguerre M, Brugada P, and Auricchio A

Subjects
Adolescent, Adult, Child, Female, Follow-Up Studies, Humans, Male, Middle Aged, Out-of-Hospital Cardiac Arrest diagnosis, Out-of-Hospital Cardiac Arrest therapy, Reference Values, Retrospective Studies, Time Factors, Ventricular Fibrillation diagnosis, Ventricular Fibrillation physiopathology, Young Adult, Defibrillators, Implantable, Electrocardiography, Out-of-Hospital Cardiac Arrest etiology, Registries, Ventricular Fibrillation complications
Abstract

Aims: To define the clinical characteristics and long-term clinical outcomes of a large cohort of patients with idiopathic ventricular fibrillation (IVF) and normal 12-lead electrocardiograms (ECGs)., Methods and Results: Patients with ventricular fibrillation as the presenting rhythm, normal baseline, and follow-up ECGs with no signs of cardiac channelopathy including early repolarization or atrioventricular conduction abnormalities, and without structural heart disease were included in a registry. A total of 245 patients (median age: 38 years; males 59%) were recruited from 25 centres. An implantable cardioverter-defibrillator (ICD) was implanted in 226 patients (92%), while 18 patients (8%) were treated with drug therapy only. Over a median follow-up of 63 months (interquartile range: 25-110 months), 12 patients died (5%); in four of them (1.6%) the lethal event was of cardiac origin. Patients treated with antiarrhythmic drugs only had a higher rate of cardiovascular death compared to patients who received an ICD (16% vs. 0.4%, P = 0.001). Fifty-two patients (21%) experienced an arrhythmic recurrence. Age ≤16 years at the time of the first ventricular arrhythmia was the only predictor of arrhythmic recurrence on multivariable analysis [hazard ratio (HR) 0.41, 95% confidence interval (CI) 0.18-0.92; P = 0.03]., Conclusion: Patients with IVF and persistently normal ECGs frequently have arrhythmic recurrences, but a good prognosis when treated with an ICD. Children are a category of IVF patients at higher risk of arrhythmic recurrences., (© The Author(s) 2019. Published by Oxford University Press on behalf of the European Society of Cardiology.)

Published
2019
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47. Internal Jugular Vein Complete Thrombosis After Dual Chamber Pacemaker Implant.

Author

Placci A, Mattioli M, Notarangelo MF, Gonzi G, and Zardini M

Abstract

Venous thrombosis after pacemaker implant is a known, although often underrecognized condition that can challenge system revision or upgrading, leading occasionally to thromboembolic complications. Several factors are considered to promote thrombus formation. Among them, alteration of blood flow mechanics due to the presence of catheters in the vessel lumen may itself play a pivotal role. Hereby we present the case of a 65-year old men who underwent a dual-chamber pacemaker implant in another institute for sick sinus syndrome by means of left cephalic venous access. About two months later he started experiencing neck swelling, pain and dysphagia. Six months later, ultrasonography and CT-scan revealed complete jugular vein thrombosis caused by a lead loop at the level of the left subclavian vein. Of note, thrombosis occurred despite proper oral anticoagulation with warfarin undertaken for coexisting atrial fibrillation. It's important to keep in mind this possible complication of pacemaker implant to allow for early diagnosis and better treatment chances. This case report is an example of how proximal catheter displacement may promote thrombus formation, probably by affecting blood flow mechanics, even in spite of proper oral anticoagulation.

Published
2016
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48. [Cardiac resynchronization therapy in a patient with congenitally corrected transposition of the great arteries and 2:1 atrioventricular block].

Author

Conte G, Coppini L, Demola MA, Zardini M, and Ardissino D

Subjects
Adult, Congenitally Corrected Transposition of the Great Arteries, Humans, Male, Atrioventricular Block complications, Atrioventricular Block therapy, Cardiac Resynchronization Therapy, Transposition of Great Vessels complications
Abstract

Congenitally corrected transposition of the great arteries (CCTGA) is a rare congenital heart disease with an atrioventricular and ventriculo-arterial discordance in which the morphological right ventricle supports the systemic circulation and the morphological tricuspid valve is the systemic atrioventricular valve. Heart rhythm disturbances and ventricular dysfunction related to electromechanical dyssynchrony are common in adult congenital heart disease patients with a systemic right ventricle. Thus, these patients may require conventional pacemaker implantation, which in the presence of ventricular dysfunction and conduction disease may further compromise cardiac performance. Indeed, cardiac resynchronization therapy may be an effective treatment option for these patients. We report the case of a patient with CCTGA and moderate depression of systemic ventricular systolic function who developed a 2:1 atrioventricular block and was treated with cardiac resynchronization therapy.

Published
2012
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